Wisdom teeth

Do you always need to remove wisdom teeth?

Many people get wisdom teeth in the mouth without problems and can use them like other molars in the mouth. If they are in the right position and have enough space, there is no reason to remove them. However, it is very common in modern humans that the space at the back of the mouth is too small for the molars to come up. Lack of space also leads to the molars tilting or being twisted in the bone and therefore not being able to come up into the mouth. Most people form all four wisdom teeth, but it is also quite common that one or more do not form.

What problems can follow wisdom teeth?

Impacted wisdom teeth. A wisdom tooth does not come up and is completely covered under the gum and hidden by bone. These wisdom teeth need to be monitored and X-rayed regularly to rule out disease around them. Often these molars can stay as long as they do not cause problems.

Partially erupted wisdom teeth. If a wisdom tooth comes up through the jawbone and opens the mucous membrane, bacteria from the oral cavity can get underneath and cause infection.

Tooth decay. The position of wisdom teeth often makes it difficult for us to brush them. Therefore, it is common that wisdom teeth decay.

Gum inflammation. The position of the molars and difficulty with cleaning often leads to inflammation around the molar. Persistent inflammation can lead to bone loss at the wisdom tooth, which often affects the molar in front of it.

I have pain from a wisdom tooth, what should I do?

We at the Dental Service care about your well-being and are happy to assist you if you have problems from a wisdom tooth. Typical symptoms from a wisdom tooth are pain in the area, swelling, bad taste or smell. It can also be sore to open the mouth and swallow, especially if the problem is in the lower jaw. There can also be a sore throat feeling on the side where the problem is and tender lymph nodes under the jawline. Contact us and we will book you an appointment. Usually an X-ray is taken and the dentist assesses what is best to do. If there is an infection, antibiotics often need to be given. If the molar needs to be removed, it is best to do so when there is no active infection.

Sometimes a 3D image needs to be taken to assess the position of the molar in relation to the jaw nerve and minimise the risk during the procedure.

A wisdom tooth needs to be removed, what can I expect?

Wisdom tooth removal can be anything from a simple tooth extraction to a surgical procedure. When it is a procedure, it is important to be well prepared and have good information about the process.

• Before the procedure is carried out, the dentist carefully reviews your medical history and medication intake. If the dentist recommends antibiotics before the procedure, it is important to take them according to instructions.
• The wisdom tooth procedures that are done at the Dental Service are done under local anaesthesia. Discuss with your dentist if you have experienced discomfort with local anaesthesia.
• It is good to let the dentist know if you feel great anxiety before the procedure.
• In most cases there is no need for general anaesthesia or sedation for such procedures, but in those cases you are referred to an oral and maxillofacial surgeon. We can give you mild anti-anxiety medication if needed.
• You do not need to fast for wisdom tooth removal under local anaesthesia, and it is important to be well rested and eat well before the procedure. You may not eat immediately after the procedure.
• Familiarise yourself well with the aftercare instructions and prepare yourself to follow them well afterwards.
• In wisdom tooth procedures, a small incision is made to reach the molar and sometimes bone needs to be removed above it. Then the molar may need to be divided into smaller pieces to remove it from the bone.
• In rare cases of lower jaw wisdom teeth, only the tooth crown is removed and the roots left behind to avoid damage to the jaw nerve. Nerve damage can cause temporary or permanent numbness in the lip.
• When the wisdom tooth has been removed, the area is cleaned and the incision stitched together. After that you often need to bite on gauze for a good while to allow the wound to heal calmly and a blood clot to form in the wound.
• After the procedure it is important to take it easy and follow the aftercare instructions carefully.

What can I expect after wisdom tooth removal?

Swelling and bruising can occur after the procedure and usually peaks after two days but then starts to go down.

You can expect pain in the first days and mild pain can last up to 10–14 days. Painkillers help to keep the pain down.

Some slight bleeding can be in the area during the first day. Note that a small amount of blood can colour the saliva so it looks like there is more bleeding than there actually is.

To promote the best possible healing and reduce the likelihood of complications, it is important to:

• Take it easy for the first two days and avoid physical exertion
• Be on liquid or soft food for at least two days after the procedure, even longer. Do not drink with a straw because of the risk of sucking up the blood clot in the wound.
• Take the medication your dentist advises you
• It is good to cool with a cold pack at first to minimise swelling and reduce pain
• Use antibacterial mouthwash for two weeks after the procedure
• Try to maintain good oral hygiene but do not brush directly on the area for the first days. Brush away from the wound.
• Smoking and vaping delay healing and greatly increase the likelihood of complications. Avoid smoking and vaping for the first days after the procedure.

Often stitches are needed after wisdom tooth removal and in most cases the dentist wants to see you about a week after the procedure to check the healing and remove the stitches.

Contact your dentist if:

• Fresh bleeding is persistent and/or you notice a blood clot forming in the area
• You experience severe pain that does not go down with painkillers
• You experience symptoms of infection such as fever, pus, and if you swell up again
• If pain increases 3–5 days after the procedure
• If you experience numbness in the area
• If you have difficulty swallowing or feel it is difficult to breathe

Outside opening hours you can contact the dentist who did the procedure directly by mobile phone or by email.

Do you want advice regarding your wisdom teeth?

We at Tannlæknaþjónustan are interested in helping you, whether you are thinking about your wisdom teeth or a planned procedure. Contact us to get personalised instructions and advice.